Provider Demographics
NPI:1346803053
Name:DEWESE, GAMEL (THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:GAMEL
Middle Name:
Last Name:DEWESE
Suffix:
Gender:M
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 TWIN VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-4620
Mailing Address - Country:US
Mailing Address - Phone:770-810-5548
Mailing Address - Fax:
Practice Address - Street 1:3414 TWIN VILLAGE LN
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-4620
Practice Address - Country:US
Practice Address - Phone:770-810-5548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2023-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA3150OtherTHERAPY